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"transvaginal color doppler ultrasound examination" and "cervical infrared treatment" are gynecological examination items performed on women, but the insured person's information shows that the gender is "male"?

recently, the medical security bureau of xilinhot city, inner mongolia, issued a notice on "xilingol kanghua urology hospital and xilingol ren'ai obstetrics and gynecology hospital's illegal use of medical insurance funds", stating that the two hospitals had suspicious clues of "male participants in gynecological projects" as high as 70 people.

the notice stated that on june 21, the anti-fraud intelligent monitoring system of the national medical insurance information platform issued suspicious data, including 47 suspicious clues involving xilingol kanghua urology hospital and 23 suspicious clues involving xilingol ren'ai obstetrics and gynecology hospital.

subsequently, the xilinhot municipal medical insurance bureau investigated and verified the matter. by verifying the medical records on site, extracting settlement data, checking settlement receipts, etc., the suspicious data were compared and checked. it was found that the suspicious data of 70 people in the two hospitals reflected the problem of "transvaginal color doppler ultrasound examination", "cervical infrared treatment" and other examination items that "the insured person's information showed that the gender was male".

the xilinhot municipal medical insurance bureau stated that the above problems were due to illegal operations of the two hospitals, involving the illegal use of 6,690.16 yuan of medical insurance funds.

on july 4, the bureau took the following actions against the two hospitals in accordance with relevant regulations:

1. summon the heads of the two hospitals and demand immediate changes.

2. recover 6,690.16 yuan of medical insurance funds used in violation of regulations and impose a fine of five times the amount.

3. terminate the medical insurance service agreement with the two hospitals.

4. hand over the clues of violations to the public security organs for further processing in accordance with the law.

the bureau said that it will use the national inspection of violation clues as a starting point to carry out special inspections across the city on "gynecological treatment for male patients", "andrological treatment for female patients", "abnormal settlement of gender-specific drugs", and "abnormal settlement of drugs for children". it will severely crack down on fraud and insurance fraud, and will not tolerate designated medical institutions that use medical insurance funds illegally.